ONCOLOGY Vol 15 No 12

Sen. Kay Bailey Hutchison (R-Tex) is supporting a bill that would authorize the National Cancer Institute (NCI) to increase research on blood cancers, particularly leukemia, lymphoma, and multiple myeloma. The Senate Health, Education, Labor,

The American Cancer Society recently announced the re-launch of its website, www.cancer.org, with a broad range of new features, including personalized content, interactive health planning tools, and online discussion groups.

A comprehensive resource from the American Cancer Society (ACS) for anyone interested in the breast cancer experience, A Breast Cancer Journey takes the reader from the time of diagnosis to after treatment is completed. It serves not only as a

Data presented at the Joint International Congress on Acute Promyelocytic Leukemia and Differentiation Therapy demonstrated that patients with acute promyelocytic leukemia (APL) treated with arsenic trioxide achieved an overall survival

The results of a clinical study demonstrating that exisulind (Aptosyn) slows tumor growth in men with advanced prostate cancer was published in the September 2001 issue of The Journal of Urology. The study is the first to show the significant

Fluorodeoxyglucose positron-emission tomography (FDG-PET) detected recurrent cancer 50% more often than did conventional imaging in people with thyroid cancer who had indications that their cancer had recurred, according to results of

A panel of top cancer specialists maintains that if a mammogram indicates a biopsy is needed, whenever possible, doctors should perform a minimally invasive breast biopsy rather than a traditional open surgical biopsy.

Drug Enforcement Administration (DEA) Administrator Asa Hutchinson made an unusual appearance at the National Press Club on October 23 to call for a balanced policy on prescription pain medications such as oxycodone (OxyContin and

According to a study presented at the 11th Annual European Cancer Conference, patients with advanced non-small-cell lung cancer (NSCLC) who received docetaxel (Taxotere) in combination with cisplatin (Platinol) achieved better results than

In a recent survey, the American Cancer Society found that many women are misinformed about breast cancer risk. According to the survey, nearly half of the respondents thought that women in the United States have a 30% to 50% chance

Older individuals are at risk for adverse events in all settings where cancer is treated. Common geriatric syndromes can complicate cancer therapy, and thus, increase patient morbidity and the costs of care. Furthermore,

Dr. Rich and colleagues present a compelling argument for the manipulation of temporal and spatial treatment parameters in chemoradiation programs. In essence, the authors address the shielding of normal tissues from the effects of cytotoxic agents. With respect to radiotherapy, this can be achieved via physical shielding by computer-generated dose algorithms using elaborate new planning technology (eg, intensity-modulated radiation therapy [IMRT]), chemical shielding with radioprotectants (eg, amifostine [Ethyol]), or temporal shielding by altered-fractionation schemes that exploit the differential alpha/beta ratios between tumor and normal tissue (eg, hyperfractionation).

Chronic pain occurs in about one-third of all cancer patients and in about three-quarters of those with advanced disease.[1] A major factor in the undertreatment of cancer pain is inadequate pain assessment.[2] Pain assessment provides the basis for inferred pathophysiology that directs diagnostic evaluation and treatment decisions. Pain syndrome identification plays an important role in this process-much of clinical medicine is based on pattern recognition of symptoms and signs, leading to a specific diagnosis and therapeutic strategy.

Older individuals are at risk for adverse events in all settings where cancer is treated. Common geriatric syndromes can complicate cancer therapy, and thus, increase patient morbidity and the costs of care. Furthermore,

The problem of pain among cancer patients is endemic. Appropriate and effective clinical responses to this problem require that the physician appreciate the cause of the pain, its underlying mechanism, its natural history, and its significance.

Older individuals are at risk for adverse events in all settings where cancer is treated. Common geriatric syndromes can complicate cancer therapy, and thus, increase patient morbidity and the costs of care. Furthermore,

Fenretinide (N-4-hydroxyphenyl-retinamide, or 4-HPR) is a semisynthetic retinoid that was initially developed as a low-dose chemopreventative agent.[1-3] Unlike other naturally occurring retinoids such as all-trans, 13-cis, and 9-cis retinoic acids, fenretinide does not induce systemic catabolism that interferes with the maintenance of effective plasma levels during long-term use. This characteristic, combined with the agent’s low toxicity and its ability to block aspects of carcinogenesis, provided the rationale for the development of fenretinide in lower doses as a chemoprevention agent for breast, prostate, and bladder cancer.

The role of adjuvant therapy following complete resection of node-positive (stage II/IIIA) non-small-cell lung cancer remains controversial. Five-year survival rates in pathologic stage II disease range from 30% to 50% and in resected stage IIIA disease from 10% to 30%. The majority of recurrences following surgery are distant metastases. This two-part review, which will conclude in the January 2002 issue, analyzes the role of adjuvant therapy in this setting, using an evidence-based approach and focusing primarily on randomized trials and meta-analyses. The key variables in evaluating these studies are elucidated, ranging from the extent of mediastinal, systemic, and "molecular" staging to the quality of the adjuvant treatments administered. Some of the potential flaws inherent in meta-analyses are reviewed. To date, there is no convincing evidence that any therapy consistently improves survival in the adjuvant setting. Postoperative radiotherapy has been associated with a significant improvement in local control, particularly in patients with pathologic N2 disease. Chemotherapy should be offered to patients in appropriate clinical trials, and active phase III trials are reviewed. Future strategies include novel chemotherapy, methods to reduce toxicity, the emerging role of neoadjuvant therapy, and the promise of new biologic agents. [ONCOLOGY 15:1549-1558, 2001]

Advances in diagnostic and therapeutic radiology and a better understanding of cell biology are being applied in practical ways to modulate treatment morbidity. Conformal radiotherapy targets the cancer precisely and can be combined with new systemically administered radiosensitizers.

Cancer patients experience pain in multiple sites and from several pathophysiologies of the symptom complex. The fluctuating nature of cancer pain intensity is a relevant clinical feature and depends on disease patterns and pain mechanisms. Breakthrough pain is defined as episodes of pain that "break through" the control of an otherwise effective analgesic therapy.

We read with interest the article and reviews of "Current Status of Radiation in the Treatment of Breast Cancer," which appeared in the April 2001 issue of ONCOLOGY.[1] These papers suggest that one of the most controversial areas in this

The population dynamics of cellular entry, traverse, and exit, through and from each phase of the cell cycle is coordinated throughout the day in the tissue of the human body. This coordination is particularly robust-ie, the daily peaks and valleys are particularly high and low-in tissues with the greatest average daily cellular proliferation. These tissues are also the most severely damaged by cancer treatments, most prominently cytotoxic drugs and ionizing irradiation.